Gastrointestinal manifestations of systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) can involve any part of the gastrointestinal tract. In this review, we list the gastrointestinal manifestations of SLE and analyze current approaches in investigating and treating these common conditions. Abdominal symptoms and signs may be due to SLE or due to medications used in the treatment of SLE. In patients with abdominal pain and active SLE, it is critical to diagnose vasculitis or thrombosis with appropriate scanning and institute early immunosuppressive or surgical treatment.

Intestinal pseudo-obstruction in inactive systemic lupus erythematosus: An unusual finding

“…SLE can involve each part of the gastrointestinal tract with oral aphthosis, esophageal dysmotility, mesenteric vasculitis, protein-losing enteropathy and pancreatitis as the most frequent manifestations [4] . Gastrointestinal involvement in SLE is rare.…”

Celiac Disease and Autoimmunity in the Gut and Elsewhere

“…[24] A more recent study from Northern Ireland did not reveal clinical evidence of SLE among a cohort of 60 celiac disease patients. [25] While gastrointestinal manifestations of SLE are common in both adults and children, [26][27][28] CD is relatively rare among this patient population but should be considered in the setting of malabsorption symptoms. False positive ANA tests may be found in patients with untreated celiac disease.…”

The Gastrointestinal Manifestations of Systemic Lupus Erythematosus: A Survey of the Literature

“…To establish a link, attention should be paid to other signs of lupus activity such as associated symptoms typical of the patient's flare, complement and serologic antibody levels and the physical examination. Hallequa noted disease related specifically to lupus was more commonly lobular on pathologic examination and was associated with elevated serum levels of double stranded DNA [127]. A paucity of lymphoid infiltrates can also be seen on pathology specimens [133].…”

“…Patients with mild to moderate abdominal complaints often present with chronic pains of insidious onset. In such cases usually presenting to the outpatient office, patients are likely to have nonemergent conditions such as medication intolerance, gastritis, serositis or bacterial overgrowth [35,127]. Simple diagnostic tests such as the lactulose hydrogen breath test for bacterial overgrowth diagnosis or treatments such as simple medication changes or antacids can be tried before more invasive diagnostic tests are employed.…”